Provider Demographics
NPI:1568180131
Name:KRATOVIL, ASHLEY (RD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:KRATOVIL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W 70TH ST PH 6S
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-4469
Mailing Address - Country:US
Mailing Address - Phone:413-575-1449
Mailing Address - Fax:
Practice Address - Street 1:101 W 70TH ST PH 6S
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-4469
Practice Address - Country:US
Practice Address - Phone:413-575-1449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86060201133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered